Cervical osteochondrosis or spondylosis occurs as a result of changes in the shape and structure of the vertebrae.Although the cervical region is quite short relative to the total length of the spine, it is perhaps the most important part of the spine.Each pair of adjacent vertebrae forms intervertebral foramina through which nerve roots exit and are directed to every muscle and organ in the upper half of the body.Vital vessels that supply the brain with blood run through other openings - in the lateral processes of these vertebrae.
Causes of osteochondrosis of the cervical spine
The causes of osteochondrosis are:
- injuries,
- “sitting” work on a monitor that is below eye level,
- physical work associated with carrying heavy loads,
- drive a car for a long time,
- work “on the phone” without using remote devices (in this case, the operator presses the receiver to his ear with his shoulder)
- Constitutional features (wry neck, congenital changes in the cervical vertebrae, short neck)
Formation of pathological changes in the vertebrae
With osteochondrosis, small sharp spikes begin to form on the edges of the vertebral bodies, which can injure neighboring structures.Most often, this occurs in response to excessive loads on the cervical spine, and is not just the result of “aging” of the intervertebral joints (remember that osteochondrosis, like arthrosis, was previously considered a degenerative, natural “age-related” disease).As the disease progresses, the vertebral endplates become denser and the height of the intervertebral discs decreases.Normally, these intervertebral discs act as shock absorbers between the vertebrae and, among other things, prevent damage to the spinal roots.As osteochondrosis progresses, there is a bulging (herniation) of the nucleus pulposus of the intervertebral disc, on which more and more pressure is exerted as the disease progresses and the “holding” ligaments on all sides are weakened.This hernia can also compress spinal structures and cause neurological manifestations of the disease.
What are the symptoms of cervical osteochondrosis?
Osteochondrosis of the cervical spine with pain syndrome
Pain in the neck area suggests pathology of the cervical spine.According to the increasing intensity of the pain syndrome, they are divided into 4 stages.In the first stage, the patient feels numbness, tingling and a “tightness” in the area of a certain muscle group.In the fourth stage - the most severe - the pain is so severe that it leads to the patient's immobility and loss of performance.
In addition to pain in the neck and back of the head, the patient notes “radiating” pain in the upper extremity and subscapular lateral areas of the chest.
Osteochondrosis of the cervical spine with radicular syndrome
The involvement of nerve roots in the process is indicated when pain, numbness and tingling spread to the lower jaw, upper back, forearm and fingers.At the same time, the patient points out that his hand “seems to be resting” and that he slept restlessly.There is morning stiffness in the finger joints that lasts no more than 10-15 minutes.With the development of radicular syndromes, a decrease in muscle strength of the upper extremities can be noted on examination.
Osteochondrosis of the cervical spine with “vertebral artery syndrome”
The involvement of blood vessels in the process (compression by a hernia protrusion or osteophyte) is indicated if the patient complains of frequent attacks of headaches, especially after a long stay in a certain position, when throwing the head back (for example, when swimming breaststroke), with tinnitus and dizziness.This clinical situation can be easily identified using ultrasound (with “Doppler mapping mode”).Ultrasound shows tortuosity of the vertebral arteries and narrowing of their lumen.In this case, surgery may be necessary because a pronounced change in blood flow in the vertebral arteries is a risk factor for stroke.
Osteochondrosis of the cervical spine with “cardiac (heart) syndrome”
This syndrome forces the patient to first contact a cardiologist, since the main complaint concerns pain in the left half of the chest, the subscapular region, which weakens or increases with physical activity or when changing posture.After a heart attack and other heart diseases have been ruled out, the patient is admitted under the supervision and treatment of a neurologist and orthopedist.
diagnosis
Four methods are used to clarify the diagnosis: radiography, ultrasound, computer tomography and magnetic resonance imaging.
The most accessible method is still an X-ray of the cervical spine;The x-ray in the lateral projection (“side view”) is most informative.With this method, the presence of injuries and gross structural changes in the vertebrae can be determined as a first approximation.
To clarify the condition of the vertebral arteries, an ultrasound examination (ultrasound) is carried out.This method determines whether blood circulation is impaired and, if so, to what extent and what type of obstacles have arisen and where they are located.
Computed tomography (CT).Allows you to more accurately assess the condition of bone structures and the degree of bone tissue density, as well as detect smaller osteophytes (bone outgrowths) than is possible with X-ray.
Magnetic resonance imaging (MRI).Such an examination is essential if there is suspicion of the presence of an inguinal hernia, the exact location of spinal cord damage and the extent of this damage.This study is necessary when the question of operational (surgical) treatment of diseases of the cervical spine is raised.
Treatment of cervical osteochondrosis
Drug treatment
The standard set of remedies for the treatment of cervical osteochondrosis reflects the goals of treatment: to relieve pain by eliminating painful muscle spasms and inflammation of the nerve roots, while increasing the mobility of the spine.To achieve these goals, painkillers, NSAIDs (non-steroidal anti-inflammatory drugs) and muscle relaxants are mainly used.It should be borne in mind that self-medication with drugs from these groups can be dangerous, since there is a possibility of misinterpretation of symptoms, as well as underestimation of the side effects of these drugs.Local (cutaneous) NSAID drugs in the form of gels are often used, and when the pain subsides, the same drugs can be used in the form of ointments.
To treat osteochondrosis at a deeper, “fundamental” level, slow-acting systemic drugs are used.These substances restore the cartilage structures of the vertebrae and prevent their further damage.The treatment cycles are long, the effect lasts for many months.
Cervical osteochondrosis has significant differences from the pathology of other parts of the spine.In this case, pain in the neck area cannot be caused by signals from the suffering spinal nerves, but by painful chronic muscle strains - all in all, this is referred to as muscle tonic syndrome.This is a completely “benign” disease that responds well to treatment with the same drugs: nonsteroidal anti-inflammatory drugs, muscle relaxants, intramuscular “blockades” with steroids.Normally, when palpating the so-called “trigger” points along the entire cervical spine and in the area of the muscles of the upper shoulder girdle, the doctor notices stabbing pain.This pathology is more common in women, most of them under 40 years old.Despite the severe pain syndrome, the neurovascular structures remain intact and blood circulation in the head area is not affected.
Manual therapy
This method of treatment can be effective for recent (often as a result of a minor injury, subluxation) pain in the neck that is not accompanied by dizziness or other changes in the nervous and circulatory systems.Resorting to manual therapy is permissible only after a thorough examination;In addition, the doctor who will perform this procedure must have sufficient experience in the field of traumatology and orthopedics.The use of manual therapy is dangerous for “old” forms of the disease!
There are two known methods of this type of intervention:
- Manipulation (short, sharp shocks of significant force aimed at eliminating subluxations, the well-known “bone clicks”);
- Mobilization (the method is based on gentle stretching of the neck after warming up and relaxing the muscular corset of the neck).
A combined method is also used, which is based on a combination of two main methods.It is important to remember that in addition to these contraindications, manual therapy is prohibited for diseases accompanied by increased blood pressure, as well as diseases of the thyroid and ENT organs.
Treatment of cervical osteochondrosis at home
Therapeutic exercises for cervical osteochondrosis
The first and most important rule for beginners in physiotherapy is not to perform exercises while overcoming painful sensations.It goes without saying that you should not start in the “acute” phase when the pain has just started.Another important recommendation is to avoid sudden movements and circular movements of the cervical spine.
Each session should begin with a short, light self-massage of the neck muscles.
This is followed by a “warm-up”:
- The arms are lowered along the body, the shoulders are at the same level, the back is straight (you can check your posture by slightly pressing your heels, shoulder blades and buttocks against the wall).We walk for 1 minute on the entire foot, 1 minute on the toes, 1 minute on the heels.
- The starting position is the same.We clench our hands into fists, raise and lower our shoulders, arms outstretched.The movements are slow, we do 20 repetitions, the last rise is 5 seconds longer.We make sure that the neck muscles are not tense.
- The starting position is the same.We tilt our heads one after the other to the right and then to the left.The movements are gentle, an incline for 8 counts, at the extreme point of the incline – hold for 8 seconds.
- The starting position is the same or sitting on a hard chair.Gently tilt your head forward, at the furthest point - hold for 8 seconds
- The starting position is the same or sitting on a hard chair.Slowly tilt your head forward until your chin touches your chest, then slowly rotate your head to the right (4 counts) and left (4 counts).Avoid overstraining the muscles.
- The starting position is the same or sitting on a hard chair.We raise our shoulders four times and then gently lower them four times.10 reps.
- The starting position is the same or sitting on a hard chair.We raise our shoulders, but now we perform circular movements from front to back 8 times.10 reps.
- We straighten our backs and check our posture.For 4 counts we bring the shoulder blades together behind our back and try to connect them.We stay at the end point for 8 seconds and then return to the starting position.
Pillow
As already mentioned, hypertension of the neck muscles is the first and often the main cause of the development of cervical osteochondrosis.A sensible selection of pillows and mattresses that ensure a relaxed and comfortable sleeping position are just as important as gymnastics, physiotherapy and medication.
When choosing a mattress, pay attention to the composition of the filling (products that consist of at least half of coconut flakes, i.e. have sufficient rigidity, are suitable).Soft spring mattresses do not ensure sufficient straightening of the spine.The optimal sleeping position is lying on your side with one or both knees pulled towards your stomach.The pillow should be positioned so that it fills the entire space between the shoulder, ear and mattress, while the crown (crown) of the head lies on the same horizontal line with the spine.Pillows that are too high, too low, or soft should be avoided.A product with an ergonomic shape is ideal, in this case with a small pinch roller on one side.
General recommendations
Pay attention to your posture.When walking or standing, the correct position is with the chest protruding forward and the stomach retracted.
Avoid sitting for long periods of time.A simple rule for the prevention of cervical osteochondrosis is known: after every 60 minutes of work, walking or warming up for 10-15 minutes is necessary.
A work chair must have a high headrest or backrest.
When sitting, your feet should be on the floor and your neck should not be tense.To do this, use special orthopedic aids: neck rolls when driving, pillows under the back.
Avoid heavy lifting.If necessary, get on your knees, hold a heavy object against your torso, and then gently stand up.You use the strength of your leg muscles, but not the “pull” of your back.
Do not bend over with your legs extended.Instead of tilting your face toward the subject, use stands or work surfaces to bring the subject closer to you.Try doing your homework while sitting on a chair or exercise ball.
If you need to use a mop, broom or rake, do not strain your arms, back, neck or lean to the side.
Avoid breaststroke.